中国血液净化

中国血液净化 ›› 2024, Vol. 23 ›› Issue (05): 347-350.doi: 10.3969/j.issn.1671-4091.2024.05.006

• 临床研究 • 上一篇    下一篇

社会经济因素对中国大陆地区血液透析发病率的影响

李思晨    赵德龙    邢增辉    刘 超    蔡广研    陈香美    孙雪峰   

  1. 100853 北京，1解放军总医院肾脏病医学部 肾脏疾病全国重点实验室 国家慢性肾病临床医学研究中心
  • 收稿日期:2024-02-05 修回日期:2024-02-23 出版日期:2024-05-12 发布日期:2024-05-12
  • 通讯作者: 孙雪峰 E-mail:xfssun@126.com

The impact of socioeconomic factors on the incidence of hemodialysis in mainland China

LI Si-chen, ZHAO De-long, XING Zeng-hui, LIU Chao, CAI Guang-yan, CHEN Xiang-mei, SUN Xue-feng   

  1. Department of Nephrology, First Medical Center of Chinese PLA General Hospital; State Key Laboratory of Kidney Diseases; National Clinical Research Center for Kidney Diseases, Beijing 100853, China
  • Received:2024-02-05 Revised:2024-02-23 Online:2024-05-12 Published:2024-05-12
  • Contact: 100853 北京，1解放军总医院肾脏病医学部 肾脏疾病全国重点实验室 国家慢性肾病临床医学研究中心 E-mail:xfssun@126.com

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摘要： 目的 明确影响中国大陆地区血液透析(hemodialysis，HD)发病率的社会经济因素。 方法 从2012—2021年国家医疗服务与质量安全报告和中国统计年鉴中，分别提取2011—2020年中国大陆31个省级地区(不含港澳台地区)的HD发病率数据和社会经济数据，以2011年人均国内生产总值(gross domestic product，GDP)水平分为低(＜3.0万元)、中等(≥3.0万元且＜8.0万元)和高(≥8.0万)3组，分析影响HD发病率的危险因素；检索文献对比不同国家地区的慢性肾脏病(chronic kidney disease,CKD)患病率。 结果 不同年份和不同人均GDP组别影响HD发病率：HD发病率在低和中等人均GDP组，2020年高于2011年(t=3.736，P=0.002；t=12.898，P＜0.001)；10年间低和中等人均GDP组HD发病率的增长率高于高人均GDP组(F=5.573，P=0.009；F=0.733，P=0.024)；乡村城镇人口比例、每千人口医疗卫生机构床位数、每千人口卫生技术人员和人均收入是影响HD发病率的独立相关因素(β=-0.172，0.232，0.225，-0.348；P=0.008，0.002，0.011，0.004)；中国大陆地区的CKD 3～5期患病率较全球平均水平低下(2.21 pmp比8.10 pmp)。 结论 伴随社会经济发展的医疗服务能力的增长，增加HD发病率；高人均GDP地区的HD发病率增长速度较低中人均GDP地区显著延缓。

关键词: 血液透析, 发病率, 社会经济

Abstract: Objective   To identify socioeconomic factors affecting the incidence of hemodialysis in mainland China.  Methods  Data on the incidence of hemodialysis and socioeconomic factors from 2011 to 2020 across 31 provinces in mainland China (excluding Hong Kong, Macao, and Taiwan) were collected from the National Medical Services and Quality Safety Reports and China Statistical Yearbooks, both covering the years from 2012 to 2021. The provinces were categorized into three groups based on their 2011 per capita GDP levels: low (<30,000 RMB), medium (＞30,000 and ＜80,000 RMB), and high (≥80,000 RMB). Risk factors influencing hemodialysis incidence were analyzed, and the prevalence rates of CKD in different countries and regions were compared.  Results  Year and per capita GDP group affect hemodialysis incidence. The incidence rates of hemodialysis in the low and medium per capita GDP groups were significantly higher in 2020 compared to 2011 (t=3.736, P=0.002; t=12.898, P＜0.001). The growth rate of hemodialysis incidence over ten years was significantly higher in the low and medium GDP group than in the high GDP group (F=5.573, P=0.009; F=0.733, P=0.024). The ratio of rural to urban population, the number of hospital beds per thousand people, the number of healthcare professionals per thousand people, and per capita income were the independent factors affecting hemodialysis incidence (B=-10.663, 6.619, 4.223 and -21.561 respectively; β=    -0.172, 0.232, 0.225 and -0.348 respectively; P=0.008, 0.002, 0.011 and 0.004 respectively). Compared to the global level, mainland China had a lower prevalence of CKD stages 3～5 (2.21 vs. 8.10 pmp).  Conclusion  With the growth of medical service capabilities that accompanies socioeconomic development, the incidence of hemodialysis increases; however, the growth rate of hemodialysis incidence in areas with high per capita GDP is significantly slower than that in areas with low and medium per capita GDP

Key words: Hemodialysis, Incidence rate, Socioeconomic

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